Citation Nr: 18147466 Decision Date: 11/06/18 Archive Date: 11/05/18 DOCKET NO. 14-21 919 DATE: November 6, 2018 ORDER Entitlement to an initial 50 percent rating, but no higher, for posttraumatic stress disorder (PTSD) with depression is granted, subject to the laws and regulations governing the payment of monetary benefits. Entitlement to a total disability rating based on individual unemployability (TDIU) is denied. REMAND Entitlement to an initial compensable rating for bilateral hearing loss prior to March 10, 2011, is remanded. FINDINGS OF FACT 1. The Veteran’s PTSD with depression is manifested by symptoms such as chronic sleep impairment, disturbances in mood and motivation, memory impairment, and difficulty in establishing and maintaining effective relationships resulting in occupational and social impairment with reduced reliability and productivity. His PTSD with depression has not been shown to produce occupational and social impairment with deficiencies in most areas. 2. The Veteran’s service-connected disabilities do not preclude substantially gainful employment. CONCLUSIONS OF LAW 1. The criteria for entitlement to an initial 50 percent rating, and no higher, for PTSD with depression have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.130, Diagnostic Code 9411. 2. The criteria for entitlement to TDIU have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.15, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1966 to July 1968. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from February 2010 and July 2011 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). In the February 2010 rating decision, the RO granted service connection for PTSD and assigned an initial 10 percent rating, effective August 19, 2009. Before the appeal was certified to the Board, in an October 2010 rating decision, the RO increased the rating for the Veteran’s PTSD to 30 percent, effective July 27, 2010. Although a higher rating was granted, the issue remained in appellate status as the maximum schedular rating was not assigned from the effective date of the award of service connection. See AB v. Brown, 6 Vet. App. 35 (1993). In the July 2011 rating decision, the RO denied TDIU. In January 2016, the Board remanded the issues of entitlement to an initial rating in excess of 10 percent for PTSD prior to July 27, 2010, and in excess of 30 percent thereafter, and the issue of entitlement to TDIU to the RO for additional evidentiary development. Following completion of that evidentiary development, the VA Appeals Management Center (AMC) continued the previous denials in a July 2018 supplemental statement of the case (SSOC). The Veteran’s VA claims file has been returned to the Board for further appellate proceedings. In the January 2016 decision referenced above, the Board granted service connection for depression. The Board also remanded the issue of entitlement to an initial compensable rating for bilateral hearing loss for the issuance of a Statement of the Case. See Manlincon v. West, 12 Vet. App. 238, 240-41 (1999). The RO failed to comply with the Board’s remand instructions regarding the hearing loss issue, necessitating another remand below. With respect to the Veteran’s depression, in a July 2016 rating decision, the RO effectuated the Board’s award of service connection for depression. For reasons which are unclear, the RO then assigned an initial 30 percent rating for the Veteran’s depression, effective May 10, 2011, then continued the 30 percent rating assigned for the Veteran’s PTSD. Both disabilities were rated under identical rating criteria, the General Rating Formula for Mental Disorders. The Board further notes (as it did in its January 2016 decision), that the RO had already used the Veteran’s depressive symptoms to assign his PTSD rating. See e.g. May 2014 Statement of the Case. As PTSD and depression are evaluated under the same rating criteria, and because the RO had already been using the Veteran’s depressive symptoms to rate his PTSD, and because the clinical evidence of record does not clearly distinguish between symptoms associated with PTSD versus depression, the Board will consider all psychiatric symptoms produced by both disabilities in assigning one combined rating under the General Rating Formula. 38 C.F.R. § 4.14 (avoidance of pyramiding). In light of the Board’s decision below, the Veteran is not prejudiced. See 38 C.F.R. § 4.25 (combined rating table providing a combined 50 percent rating for two service-connected disabilities each rated as 30 percent disabling).   FACTUAL BACKGROUND The Veteran filed a claim of entitlement to service connection for PTSD on August 19, 2009. In connection with his claim, he was afforded a VA examination in January 2010 at which he reported symptoms such as impaired sleep, dwelling on his Vietnam experiences, and an increased startle response. He reported that he had been married for 37 years although he was not particularly close to his spouse nor did they get along well. He formerly worked in construction but had been forced to retire due to emphysema and received Social Security disability for that condition. He spent his days feeding his cows and cutting hay. He said he visited with no one. On examination, the Veteran denied suicidal ideation. He endorsed homicidal ideation but denied intent. He was fully oriented, displayed no anxiety or hallucinations and his insight and judgment were intact. The diagnosis was PTSD and the examiner characterized the Veteran’s symptoms as mild. The examiner indicated that there was no evidence that the psychiatric disorder negative impacted the Veteran’s employment nor was there was impairment in thought processing or communication. A GAF of 65 was assigned. In September 2010, the Veteran’s spouse submitted a statement describing the Veteran’s symptoms. According to his spouse, the Veteran did not want to socialize, did not shower unless asked to, and had lost weight. She indicated that it was difficult to maintain a relationship with the Veteran. She also stated that the Veteran also kept the TV on all night to deal with his nightmares. At a September 2010 VA examination, the Veteran reported that there had not been a significant change in his functioning, although he found himself waking up hollering four to fives times weekly. It took him two to three hours to get back to sleep. He acknowledged intrusive thoughts. He did not leave the house much, and had gone out to eat only once since January. He remained married but was not close to his wife. She was always “bitching” at him to take a shower. He indicated that he liked to shower every two to three weeks only. He indicated that he did not visit with anyone because “I ain’t got no use to see anybody.” The Veteran’s mood was depressed but he denied suicidal ideation. He again reported some homicidal ideation but denied intent. The diagnosis was PTSD and the examiner indicated that there had not been a change from the prior examination. There was still no evidence that PTSD symptoms precluded employment. The Veteran did report considerable social isolation but his PTSD did not preclude activities of daily living. The examiner also indicated that the Veteran could appear to meet the criteria for a diagnosis of depression. A GAF of 65 was assigned. In January 2011, the Veteran was referred to the VA mental health clinic in connection with his complaints of PTSD and nightmares. He indicated that since he retired in 2005, he thought of Vietnam all the time. On February 25, 2011, the Veteran completed a mental health evaluation and was assigned a GAF score of 45. The Veteran stated that he felt anxiety, irritability, fatigue, and had several nightmares each week. He denied suicidal ideations. In April 2011, the VA examiner who conducted the January and September 2010 examinations noted that he had reviewed the Veteran’s VA mental health treatment records and noted that he had received significantly lower GAF scores than had been assigned at the January and September 2010 VA examinations. He indicated that it appeared that the Veteran had been having significant marital problems and depression which may explain the lower GAF scores assigned by the mental health clinic. The examiner indicated, however, that there was still no evidence that the Veteran’s PTSD precluded employment. In a May 2011 statement, the Veteran indicated that PTSD warranted at least a 50 percent rating. VA clinical records dated from June 2011 to April 2014 document continued psychiatric symptoms such as nightmares, poor sleep, depression, intrusive thoughts, and irritability. The Veteran consistently denied suicidal and homicidal ideation, although he reported angry and hostile thoughts towards others. He reported that he remained married and had adult children nearby. A full suicide risk assessment was completed in April 2013 and again in October 2015. The assessments were negative. The Veteran had a safety plan to call his sister if suicidal thought did occurred. During this period, his treatment providers assigned GAF’s of between 50-55. At a VA examination in May 2016, the VA examiner noted that the Veteran had symptoms of depressed mood, anxiety, chronic sleep impairment, disturbances of motivation and mood, and difficulty in establishing and maintaining effective work and social relationships. The Veteran denied having past or present suicidal ideation. He denied current homicidal ideation but reported angry and aggressive thoughts towards his neighbors for many years. He denied thoughts of harming another for the past six months. The examiner added that it was not possible to differentiate the symptoms of PTSD with the symptoms of alcohol use disorder in remission that exacerbated the Veteran’s symptoms of anxiety and depression. The Veteran told the examiner that he is still married and talked to his children, and had limited contact with three of his four siblings. He did not have suicidal ideations. The examiner indicated that the Veteran’s psychiatric disability resulted in occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self care and conversation. In an October 2016 addendum, the VA examiner found that the Veteran’s limitations and restrictions regarding his functional capacity with employment were related to “physical conditions rather than psychological or mental difficulties.” He indicated that it was his opinion that the Veteran’s psychiatric symptoms were best categorized as mild or transient, causing decreased work efficiency and ability to perform occupational tasks only during periods of significant stress. The examiner also opined that the Veteran’s symptoms appeared to be controlled by medication. In November 2016, the VA examiner opined that the Veteran’s tinnitus and hearing loss did not impact the Veteran’s ability to work. 1. Entitlement to an initial rating in excess of 10 percent for PTSD with depression prior to July 27, 2010, and in excess of 30 percent thereafter Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § Part 4. Separate diagnostic codes identify the various disabilities. The basis of disability evaluations is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. Evaluations are based upon lack of usefulness of the part or system affected, especially in self-support. 38 C.F.R. § 4.10. Where a claimant appeals the initial rating assigned for a disability when a claim for service connection for that disability has been granted, evidence contemporaneous with the claim for service connection and with the rating decision granting service connection would be most probative of the degree of disability existing at the time that the initial rating was assigned and should be the evidence “used to decide whether an [initial] rating on appeal was erroneous . . .” Fenderson v. West, 12 Vet. App. 119, 126 (1999). If later evidence obtained during the appeal period indicates that the degree of disability increased or decreased following the assignment of the initial rating, “staged” ratings may be assigned for separate periods of time based on facts found. Id. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability is resolved in favor of the Veteran. 38 C.F.R. § 4.3. In all cases, the Board must determine the value of all evidence submitted, including lay and medical evidence. Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). The evaluation of evidence generally involves a three-step inquiry. First, the Board must determine whether the evidence comes from a “competent” source. The Board must then determine if the evidence is credible, or worthy of belief. Barr v. Nicholson, 21 Vet. App. 303, 308 (2007). The third step of this inquiry requires the Board to weigh the probative value of the proffered evidence in light of the entirety of the record. In this function, the Board may properly consider internal inconsistency, facial plausibility, and consistency with other evidence submitted on behalf of the claimant. Caluza v. Brown, 7 Vet. App. 498, 511–12 (1995); Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997). The standard of proof to be applied in decisions on claims for VA benefits is set forth in 38 U.S.C. § 5107 (b). Under that provision, VA shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107 (b); see also Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The Veteran’s PTSD with depression is rated under the criteria contained in the General Rating Formula for Mental Disorders. 38 C.F.R. § 4.130. A 10 percent rating is assigned for occupational and social impairment due to mild or transient symptoms which decrease work efficient and ability to perform occupational tasks only during periods of significant stress or symptoms controlled by continuous medication. A 30 percent rating is warranted for occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks that occur weekly or less often, chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). A 50 percent rating is warranted for occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect, circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to compete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. A 70 percent rating is assigned when there is objective evidence demonstrating occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or worklike setting); inability to establish and maintain effective relationships. In Mauerhan v. Principi, 16 Vet. App. 436 (2002), the U.S. Court of Appeals for Veterans Claims (Court) held that use of the term “such as” in 38 C.F.R. § 4.130 demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, but rather are to serve as examples of the type and degree of symptoms, or their effects, that would justify a particular rating. Accordingly, the evidence considered in determining the level of impairment under section 4.130 is not restricted to the symptoms provided in the diagnostic code. Rather, VA must consider all symptoms of a claimant’s condition that affect the level of occupational and social impairment, including, if applicable, those identified in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. More recently, the U.S. Court of Appeals for the Federal Circuit (Federal Court) held that “a veteran may only qualify for a given disability rating under § 4.130 by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration.” Vazquez-Claudio v. Shinseki, 713 F.3d 112, 116 (Fed. Cir. 2013). The Federal Circuit explained that in the context of a 70 percent rating, section 4.130 “requires not only the presence of certain symptoms but also that those symptoms have caused occupational and social impairment in most of the referenced areas.” Id. at 118. The Federal Circuit indicated that “[a]lthough the veteran’s symptomatology is the primary consideration, the regulation also requires an ultimate factual conclusion as to the veteran’s level of impairment in ‘most areas.’” Id. According to the Fourth Edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, a GAF score is a scale reflecting the “psychological, social, and occupational functioning on a hypothetical continuum of mental health-illness.” Carpenter v. Brown, 8 Vet. App. 240, 242 (1995); Richard v. Brown, 9 Vet. App. 266 (1996) (citing the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders 32 (4th ed. 1994) (DSM-IV)). The Board notes that an interim final rule was issued on August 4, 2014, that replaced the DSM-IV with the DSM-5. GAF scores have been removed from DSM-5. The provisions of this interim final rule, however, do not apply to the instant case, as these provisions only apply to applications for benefits that are received by VA or that are pending before the RO on or after August 4, 2014. See 79 Fed. Reg. 45,093, 45,094 (Aug. 4, 2014). VA adopted as final, without change, the interim final rule, effective March 19, 2015. 80 Fed. Reg. 53, 14,308 (March 19, 2015). Applying the facts in this case to the legal criteria set forth above, and affording the Veteran the benefit of the doubt, the Board concludes that an initial 50 percent rating for PTSD with depression have been met since the award of service connection. According to the statements of the Veteran and his spouse, as well as the VA treatment records, the Veteran’s PTSD with depression has been manifested by symptoms such as chronic sleep impairment, disturbances in mood and motivation, memory impairment, and difficulty in establishing and maintaining effective relationships. The Board finds that these symptoms have resulted in occupational and social impairment with reduced reliability and productivity. The Veteran has consistently described an extremely strained relationship with his spouse. He indicates that he visits with no one else. The Veteran’s social impairment was described as considerable. In addition, his clinical records reflect GAF scores ranging from 45 to 55, reflecting serious to moderate disability. GAF scores ranging from 41 to 50 indicate serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) OR any serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job). GAF scores ranging from 51 to 60 indicate moderate symptoms (e.g., flat affect and circumstantial speech, occasional panic attacks) OR moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peer or coworkers). Carpenter v. Brown, 8 Vet. App. 240, 242 (1995); Richard v. Brown, 9 Vet. App. 266 (1996) (citing the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders 32 (4th ed. 1994) (DSM-IV)). The Board has considered that the GAF scores assigned by the VA examiner in January and September 2010 reflect less serious symptoms than those documented in his treatment records. The Board has also considered his characterization of the Veteran’s disability as mild. Given the conflict between the lay evidence and the treatment records versus the findings of the examiner, the Board has resolved the benefit of the doubt in the Veteran’s favor. The Board, however, finds that the Veteran’s PTSD with depression does not more nearly reflect the criteria for a 70 percent or higher rating. He has consistently denied suicidal ideation. Examinations have consistently shown that the Veteran has been fully oriented and free of impaired speech and inappropriate behavior. Although he reports feeling angry towards others and had admitted to homicidal ideation, he has consistently denied intent and has exhibited no periods of violence. Although he reports that he likes to shower only once every two to three weeks, he has consistently been described as appropriately dressed and groomed. He has not been shown to be unable to maintain personal hygiene. Moreover, he has remained married to his spouse for decades and apparently has been able to maintain a relationship with relatives, including his children and siblings. Finally, although the Veteran exhibits considerable social impairment, his service-connected psychiatric symptoms do not produce significant occupational impairment. Rather, the Veteran has indicated that he retired due to emphysema, not as a result of his service-connected psychiatric disability. After considering the record in its entirety, the Board concludes that the most probative evidence shows that the Veteran’s service-connected psychiatric disability does not produce occupational and social impairment with deficiencies in most areas such as work, school, family relations, judgment, thinking or mood, nor does it produce total social and occupational impairment. In summary, the Board has carefully considered the Veteran’s symptoms and how they affect his level of occupational and social functioning. After so doing, the Board concludes that the most probative evidence reflects that the criteria for an initial 50 percent, and no higher, for PTSD with depression have been met. Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 2. Entitlement to TDIU VA will grant a total rating for compensation purposes based on unemployability when the evidence shows that the Veteran is precluded from obtaining or maintaining any gainful employment consistent with his education and occupational experience, by reason of his service-connected disabilities. 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.16. If the total rating is based on a disability or combination of disabilities for which the Schedule for Rating Disabilities provides an evaluation of less than 100 percent, it must be determined that the service-connected disabilities are sufficient to produce unemployability without regard to advancing age. 38 C.F.R. § 3.341. In evaluating total disability, full consideration must be given to unusual physical or mental effects in individual cases, to peculiar effects of occupational activities, to defects in physical or mental endowment preventing the usual amount of success in overcoming the handicap of disability, and to the effects of combinations of disability. 38 C.F.R. § 4.15. A TDIU for compensation purposes may be assigned where the schedular rating is less than total, when it is found that the disabled person is unable to secure or follow a substantially gainful occupation as a result of a single service-connected disability ratable at 60 percent or more, or as a result of two or more service-connected disabilities, provided at least one disability is ratable at 40 percent or more, and there is sufficient additional service-connected disability to bring the combined rating to 70 percent or more. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.340, 3.341, 4.16(a). For the above purpose of one 60 percent disability or one 40 percent disability, disabilities resulting from a common etiology or a single accident will be considered as one disability. 38 C.F.R. § 4.16(a)(1). For a veteran to prevail on a claim for a TDIU, the record must reflect some factor which takes the case outside the norm. The sole fact that a claimant is unemployed or has difficulty obtaining employment is not enough. A high rating in itself is a recognition that the impairment makes it difficult to obtain and keep employment. The question is whether a veteran is capable of performing the physical and mental acts required by employment, not whether the Veteran can find employment. See 38 C.F.R. § 4.16(a); Van Hoose v. Brown, 4 Vet. App. 361 (1993). In determining whether an appellant is entitled to a TDIU, neither the Veteran’s nonservice-connected disabilities nor advancing age may be considered. Furthermore, it is the policy of VA that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service connected disability shall be rated totally disabled. 38 C.F.R. § 4.16(b). Thus, if a veteran fails to meet the applicable percentage standards enunciated in 38 C.F.R. § 4.16(a), an extra-schedular rating is for consideration where the veteran is unemployable due to service connected disability. 38 C.F.R. § 4.16(b); see also Fanning v. Brown, 4 Vet. App. 225 (1993). Again, neither the Veteran’s nonservice-connected disabilities nor advancing age may be considered in the determination. The Veteran contends that his service-connected disabilities entitle him to a total disability rating based on individual unemployability. In light of the Board’s decision above, the Veteran is in receipt of a 50 percent rating for PTSD. Service connection is also in effect for tinnitus and hearing loss, each rated as 10 percent disabling. His combined rating is 60 percent. As the Veteran does not have a single disability rated at 60 percent or more, nor a combined disability rating of 70 percent or more, he does not meet the threshold schedular criteria for TDIU. However, it is the policy of VA that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disability shall be rated totally disabled. 38 C.F.R. § 4.16(b). The Board has therefore considered the Veteran’s entitlement to TDIU on an extraschedular basis but concludes that As summarized above, the VA examiners opined that the Veteran’s service-connected disabilities do not preclude him from obtaining gainful employment. His symptoms from PTSD with depression were reduced with medication, and his tinnitus and bilateral hearing loss did not preclude him from gainful employment according to the VA examiners. In fact, the Veteran has described no symptoms of hearing loss or tinnitus which would preclude employment consistent with his educational and occupational history. The Board recognizes that the Veteran’s service-connected psychiatric disability results in significant impairment, particularly maintaining effective relationships, but finds that the 50 percent rating assigned for the appellant’s PTSD with depression is recognition that the impairment associated with his disability. The Board has considered the fact that the Veteran was awarded disability benefits from the Social Security Administration. However, those records indicate that the award was the result of nonservice-connected COPD or emphysema. In fact, the Veteran has acknowledged that he retired due to complications with his emphysema. Again, the Board recognizes that the Veteran is not currently working. The ultimate question, however, is whether the Veteran’s service-connected disabilities, without regard to any nonservice-connected disabilities, prevents him from securing or following a substantially gainful occupation. As set forth above, the most probative evidence of record indicates that they do not. The Board therefore finds that the preponderance of the evidence is against a finding that the Veteran’s service-connected disabilities alone render him unable to secure or follow a substantially gainful occupation. Thus, referral for extraschedular TDIU consideration is not warranted.   REMAND 1. Entitlement to an initial compensable rating for bilateral hearing loss prior to March 10, 2011, is remanded. In its January 2016 decision, the Board noted that in a February 2010 rating decision, the RO granted service connection for bilateral hearing loss and assigned an initial noncompensable rating, effective August 19, 2009. The Board found that in a July 2010 statement, the Veteran had expressed disagreement with the initial rating assigned. The Board therefore remanded the issue of entitlement to an initial compensable rating for bilateral hearing loss for the issuance of a Statement of the Case. See Manlincon v. West, 12 Vet. App. 238, 240-41 (1999). The RO failed to comply with the Board’s remand instructions, necessitating another remand. The Board notes that in a July 2011 rating decision, the RO assigned a 10 percent rating for hearing loss, effective March 10, 2011, which was the rating sought by the Veteran. See e.g. May 2011 VA Form 21-4138. However, the Veteran’s entitlement to a compensable rating for the period from August 19, 2009, to March 9, 2011, remains at issue, necessitating the issuance of a Statement of the Case.   The matter is REMANDED for the following action: Send the Veteran a Statement of the Case addressing the issue of entitlement to an initial compensable rating for bilateral hearing loss prior to March 10, 2011. If the Veteran perfects an appeal by submitting a timely VA Form 9, the issue should be returned to the Board for further appellate consideration. K. Conner Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD H. Yun, Associate Counsel